[Peritubal adhesions and hysterosalpingography]

Area of Science:

• Radiology
• Gynecology
• Pelvic Health

Background:

• Pelvic adhesions, often resulting from infections like salpingitis or peritonitis, can impact tubal function.
• Hysterosalpingography (HSG) is a key imaging technique in evaluating female reproductive health.
• Direct visualization of adhesions via HSG is limited, necessitating indirect radiological signs.

Purpose of the Study:

• To identify and analyze all hysterosalpingographic signs indicative of tubal involvement due to pelvic adhesions.
• To enhance the diagnostic accuracy of HSG in cases of suspected adhesive tubal disease.

Main Methods:

• Retrospective analysis of controlled patient series with diagnosed pelvic adhesions.
• Detailed examination of hysterosalpingographic images to identify specific radiological findings.
• Correlation of radiological signs with clinical and surgical findings of tubal involvement.

Main Results:

• Contrast medium pooling around the fallopian tubes is a recognized sign but not the most frequent.
• Absence of contrast pooling does not rule out tubal involvement, especially when adhesions affect the proximal tubal ends.
• Other subtle radiological signs were identified and analyzed in the context of adhesive tubal disease.

Conclusions:

• Hysterosalpingography offers valuable indirect signs for diagnosing tubal involvement in pelvic adhesions.
• Radiologists and clinicians should be aware of a spectrum of HSG findings beyond contrast pooling.
• Improved interpretation of HSG can lead to better management of infertility and pelvic pain associated with adhesions.